Got No Strings

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0:00:42 > 0:00:46- I'm leaving.- I'm not entirely sure what you expect me to do, Mr Douglas.

0:00:46 > 0:00:48I expect you to do whatever it takes.

0:00:48 > 0:00:51- So if I apply for Clinical Lead? - May the best man win.

0:00:51 > 0:00:53This is your doing, isn't it?

0:00:53 > 0:00:56Rafi's been offered another anaesthetist job with higher pay than Nottingham.

0:00:56 > 0:00:58I'm supposed to believe that's just a coincidence.

0:00:58 > 0:01:02So, you're going to Ibiza for fortnight is more important

0:01:02 > 0:01:03than living with me?

0:01:03 > 0:01:06And you don't think I'd like to spend more time with my kids.

0:01:06 > 0:01:08What's stopping you?

0:01:08 > 0:01:11- I hope you're not too disappointed? - What? That I didn't get a job I deserve?

0:01:11 > 0:01:13I think it'd be a good idea to appoint a second lead.

0:01:13 > 0:01:15Really? Like a second in command?

0:01:15 > 0:01:17Yeah.

0:01:23 > 0:01:27HEART MONITOR BEEPS

0:01:27 > 0:01:28CLASSICAL MUSIC PLAYS

0:01:28 > 0:01:29ROCK MUSIC PLAYS

0:01:29 > 0:01:34- Are you listening to a single thing I say?- You said clamp the ileocolic vessel.

0:01:34 > 0:01:36Yeah, clamp it. Not clamp it then hide it

0:01:36 > 0:01:39where not even a crack-team of Navy Seals could find it!

0:01:42 > 0:01:47This guy's heart's like a diesel pump. Right, there. There. Clamp it!

0:01:47 > 0:01:48Clamp it!

0:01:58 > 0:02:00All right. Now, now, clamp it! Clamp it!

0:02:00 > 0:02:02- Got it?- Yeah.- OK. Ready?

0:02:02 > 0:02:08One, two, three...

0:02:08 > 0:02:09For the love of God! Come on.

0:02:11 > 0:02:14OK, there. Here, here, here. Clamp it. You got it?

0:02:14 > 0:02:19OK, here we go. Here we go. One, two, three.

0:02:20 > 0:02:24Ooh! Hey, hey! All right.

0:02:24 > 0:02:28OK, let's suture this bad boy and we're home and dry.

0:02:28 > 0:02:33Nowhere in the log does it say you're booked in this theatre now.

0:02:33 > 0:02:35Well, believe it or not,

0:02:35 > 0:02:37this actually started in the Treatment Room,

0:02:37 > 0:02:42it was just a simple wound suture until this guy decided to have a full scale graft blow out.

0:02:42 > 0:02:45- Really?- But luckily we were here to rise to the occasion. Right?

0:02:45 > 0:02:49- Most certainly were. - Had your patient been properly sutured in the first place,

0:02:49 > 0:02:51he wouldn't have needed to be re-admitted,

0:02:51 > 0:02:54let alone to suffer further complications requiring theatre.

0:02:57 > 0:02:58Are you kidding me?

0:03:01 > 0:03:05- I'm so sorry. - OK. You made it.

0:03:05 > 0:03:10Thank you. It's like a madhouse in there.

0:03:10 > 0:03:11You still need a break.

0:03:11 > 0:03:14Yeah. I know. But, you know what it's like.

0:03:15 > 0:03:18Do you remember when we used to sit outside

0:03:18 > 0:03:20St Thomas's feeding the squirrels?

0:03:20 > 0:03:24Yeah. You used to call them "Rats with fancy tails and good PR."

0:03:24 > 0:03:27Yeah, that's exactly what they are!

0:03:27 > 0:03:30We do need to make time to be together.

0:03:30 > 0:03:32Yeah, I know.

0:03:32 > 0:03:37- It doesn't happen naturally now. Not with us both working. - HER BEEPER GOES OFF

0:03:38 > 0:03:40And then, there was Hanssen...

0:03:41 > 0:03:43I'm sorry.

0:03:45 > 0:03:46Bye.

0:03:51 > 0:03:55Mr Thorne, septic leg ulcer. Yesterday, you...

0:03:55 > 0:03:58..Debrided it. Yep. OK, that looks good.

0:03:58 > 0:03:59You're going home. Next.

0:04:00 > 0:04:02Mrs Coolidge. You removed her gall bladder.

0:04:02 > 0:04:04All right. Show me.

0:04:06 > 0:04:08Mrs Coolidge.

0:04:08 > 0:04:11That's exemplary. You're going home. Next.

0:04:11 > 0:04:15Miss Quinn, broken ribs. She slipped in the shower.

0:04:15 > 0:04:18- Right.- You sutured her pretibilal laceration.

0:04:18 > 0:04:21You slipped on your shower gel bottle. How could I forget?

0:04:21 > 0:04:23All right, let's take a look.

0:04:25 > 0:04:28- How does that feel? - It feels fine.

0:04:28 > 0:04:30OK, you're going home.

0:04:30 > 0:04:33Just no kick boxing for next couple of weeks. Promise?

0:04:35 > 0:04:39Now, Mr McPhee's pancreatic ductal-type adenocarcinoma.

0:04:39 > 0:04:42Ms Broadhurst would like to handle this one.

0:04:42 > 0:04:44All right, why am I getting all the dog cases,

0:04:44 > 0:04:46while she cops all the interesting work?

0:04:46 > 0:04:49Well, she is the boss. And a fellow.

0:04:49 > 0:04:51Authority loves an academic.

0:04:51 > 0:04:54Right. There's a repatriation medical insurance case arriving.

0:04:54 > 0:04:58- Doctor attending landed at the airport and called it in. - From where?

0:04:58 > 0:05:02Gambia. Patient has impaired consciousness. Mystery illness.

0:05:02 > 0:05:04- Age?- Young girl, 19. - Tropical infection?

0:05:04 > 0:05:08- Possibly. Arriving in Wyvern in ten minutes.- This one's mine.

0:05:11 > 0:05:12Thanks.

0:05:13 > 0:05:15You look like how I feel.

0:05:15 > 0:05:18Cream-crackered. My shop.

0:05:18 > 0:05:20Double shifts.

0:05:20 > 0:05:22Tell me about it.

0:05:22 > 0:05:23Need the cash.

0:05:23 > 0:05:27What is it - drug habit? Gambling debts?

0:05:27 > 0:05:29Owe money to the Mafia?

0:05:29 > 0:05:30Ibiza.

0:05:30 > 0:05:35- Nice.- Saturday the seventh. Eleven days' time.

0:05:35 > 0:05:39This is me...

0:05:41 > 0:05:44Would madam care for another Margarita?

0:05:44 > 0:05:47- Big news!- What?!

0:05:47 > 0:05:50We have a moving in date! I've signed the papers.

0:05:50 > 0:05:52We take up residence on Saturday the seventh!

0:05:55 > 0:05:56Yay!

0:06:09 > 0:06:12SHE SCREAMS

0:06:12 > 0:06:14Primal screaming.

0:06:14 > 0:06:20Reiki healing. Faith healing. Hopi ear-candling. Applied kinesiology.

0:06:20 > 0:06:21Bio-resonance therapy.

0:06:21 > 0:06:24Crystals. Fasting and urine therapy, you name it,

0:06:24 > 0:06:26Annabelle Taylor has tried it.

0:06:26 > 0:06:29She's a bit young to have thyroid cancer.

0:06:29 > 0:06:32- She had lung cancer when she was 17.- What?

0:06:32 > 0:06:33Totally unrelated.

0:06:33 > 0:06:36These two cancers have no connection or link to each other whatsoever.

0:06:36 > 0:06:39That's terrible. What're the odds of that?

0:06:39 > 0:06:4233.7 million to one.

0:06:42 > 0:06:46Approximately. Miss Taylor should do the European lottery.

0:06:46 > 0:06:48She'd have more chance of winning that

0:06:48 > 0:06:51than she had contracting those two cancers in her short life.

0:06:51 > 0:06:53So, you're proposing a thyroidectomy?

0:06:53 > 0:06:57A retrosternal mass, compromising the trachea, with limited access.

0:06:57 > 0:06:59Thank you.

0:06:59 > 0:07:00So without a sternotomy,

0:07:00 > 0:07:04a standard thyroidectomy makes it a very challenging procedure. But one,

0:07:04 > 0:07:09if it were executed correctly, that should rid Annabelle Taylor of her tumour permanently.

0:07:09 > 0:07:14I expect I will need cardiac cover, because of that.

0:07:14 > 0:07:17That's some mass behind the sternum! Goes all the way into the chest.

0:07:17 > 0:07:20Quite a novelty, don't you think? She'll be very testing.

0:07:20 > 0:07:21Would you like to take a look at her for me?

0:07:21 > 0:07:25Gosh, yes, I'd love to, but my schedule today is already...

0:07:25 > 0:07:29I paged, because I value your opinion. And I think you'll enjoy Miss Taylor.

0:07:29 > 0:07:33- She is something of an eccentric. - All the alternative medicines?

0:07:33 > 0:07:36Yes, and her rather original relationship with her illness.

0:07:36 > 0:07:39- Really? - She calls her cancer "Raymond."

0:07:47 > 0:07:49One of my old team became a repatriation doctor.

0:07:49 > 0:07:52Left the NHS to join a big international medical agency.

0:07:52 > 0:07:56In case it's an infection, let's clear the side room. She'll need to be isolated.

0:07:56 > 0:08:00Flew all over the place, First Class, bringing sick Britons back to Blighty. Aspen, Seychelles...

0:08:00 > 0:08:02What was she presenting with at the hospital out there?

0:08:02 > 0:08:06- They didn't say.- OK, can you liaise with the Infectious Diseases Unit?

0:08:06 > 0:08:09Get any tropical infection updates for West Africa.

0:08:09 > 0:08:12Said it was like being the James Bond of the medical world.

0:08:12 > 0:08:14International jet-set GP. Another day, another continent.

0:08:17 > 0:08:21Ten nights with his own personal butler! My ex-registrar,

0:08:21 > 0:08:23looking after some businessman stroke-victim.

0:08:23 > 0:08:25Then a private jet home.

0:08:25 > 0:08:28I mean, how jammy is that?

0:08:29 > 0:08:32Doctor Jeremy Summerville, thank you so much for meeting us.

0:08:32 > 0:08:33Mike Spence.

0:08:33 > 0:08:36So, Louisa Tindle, 19, student from Gloucestershire.

0:08:36 > 0:08:38Was on a voluntary placement thing in Gambia.

0:08:38 > 0:08:40Collapsed and admitted to hospital four days ago.

0:08:40 > 0:08:44- Breathless, high temperature, dizzy and abdo pain. - Why'd she collapse?

0:08:44 > 0:08:47No idea. The abdo pains became progressively worse.

0:08:47 > 0:08:52Hospital never reached a verdict, pretty basic facilities out there. Luckily she had top-line insurance.

0:08:52 > 0:08:56- She was conscious when collected? - Weak, but yes, lost consciousness on the plane.

0:08:56 > 0:08:58Agitated, a lot of pain. Out like a light.

0:08:58 > 0:09:02Breathing's normal, 94% Sats but hasn't regained consciousness.

0:09:02 > 0:09:05- Any vomiting? Diarrhoea? - Just shut down.

0:09:05 > 0:09:09Well, she seems stable, breathing on her own. Let's find out what's wrong.

0:09:09 > 0:09:12Doctor Summerville, Alex Broadhurst, Head of Department of the Acute Admissions Unit.

0:09:12 > 0:09:14Right. Good. Pleased to meet you.

0:09:14 > 0:09:18- I can take this case from here, - It's OK. We took the call, we made the catch.

0:09:18 > 0:09:20I'll take over now, thank you, Mr Spence.

0:09:20 > 0:09:25OK, right. Well, sorry to bother you, old fruit. My mistake.

0:09:25 > 0:09:26I just assumed you were in charge.

0:09:30 > 0:09:31This is Mr Brodrick.

0:09:31 > 0:09:33Owen.

0:09:33 > 0:09:36Phosphorous burns to his posterior. I've debrided them in theatre,

0:09:36 > 0:09:40but he will need hourly obs and dressings changed twice daily, minimum.

0:09:40 > 0:09:42Notes, where are the notes?

0:09:42 > 0:09:44Ooh, that sounds painful.

0:09:44 > 0:09:47Go on. Get it over with. Have a laugh. Chuckle-away, ladies.

0:09:47 > 0:09:52- Then we'll call it a day, shall we? - Laugh?- Lads who did this are still laughing now.

0:09:52 > 0:09:55Somebody did this on purpose?

0:09:55 > 0:10:00I should never have turned me back. Lesson One when teaching poxy little beam-trawler deck hands

0:10:00 > 0:10:02in the correct use of a hand-held rescue flare.

0:10:02 > 0:10:04Do not turn your back. My own fault.

0:10:04 > 0:10:06I'd have had you down as a miner.

0:10:06 > 0:10:10I was. 22 years in Cwmbargoed Pits.

0:10:11 > 0:10:15Now I'm teaching trawler boys safety at sea. It's murder.

0:10:15 > 0:10:17Must make a nice change, the wide ocean to being underground.

0:10:19 > 0:10:21Give me underground, any day.

0:10:21 > 0:10:23- Is there anyone you'd like us to call?- Only my mother.

0:10:23 > 0:10:27Shall I give her a ring, tell her you're all right? Maybe she wants to visit?

0:10:27 > 0:10:29Joking, aren't you? I'd rather have another flare up my whatsit

0:10:29 > 0:10:32- than get mother in here. - She a bit scary?

0:10:32 > 0:10:35You've seen what's in the middle of the Welsh flag.

0:10:35 > 0:10:38- They used my mother's head for the profile.- Really?

0:10:40 > 0:10:42No mates you want us to call?

0:10:42 > 0:10:46Nah. Only pub-mates. Pub-mates don't do hospital visits.

0:10:46 > 0:10:50Excuse us a sec.

0:10:51 > 0:10:54- Um, Lleucu...- The van. - What?

0:10:54 > 0:10:57Your job, sort the van with your uncle's friend.

0:10:57 > 0:10:58Do it tonight. Don't forget.

0:11:09 > 0:11:11Well?

0:11:11 > 0:11:14Hanssen wants me to have a look at a case.

0:11:14 > 0:11:19- I ate your Danish.- Malignant thyroid tumour, she's only 25.

0:11:19 > 0:11:21That is young.

0:11:21 > 0:11:23- Yeah, and it's huge. - Why does he want you?

0:11:23 > 0:11:27Well, it reaches right down her neck into her chest.

0:11:27 > 0:11:30- So he wanted my input. - Doesn't he always?

0:11:30 > 0:11:33I'm only trying to do my job.

0:11:33 > 0:11:35You do about four peoples' jobs.

0:11:35 > 0:11:38I can't say no. She's already had lung cancer.

0:11:38 > 0:11:41Jeez. How much bad luck can one person have?

0:11:41 > 0:11:45Exactly. So Hanssen wants me to consult on the cardio aspect.

0:11:45 > 0:11:48- There's no-one else? - Consult. Not operate.

0:11:48 > 0:11:51- It's not going to make you late tonight?- No.

0:11:51 > 0:11:53No. Look, if it looks like it's running late,

0:11:53 > 0:11:56I'll have a word with him. I'll sort it out, OK?

0:11:56 > 0:12:00Sometimes it feels like there's three of us in this marriage.

0:12:09 > 0:12:11Let's review, shall we?

0:12:11 > 0:12:13Did she have vaccinations prior to travel?

0:12:13 > 0:12:17- Yellow Fever, Diphtheria, Typhoid. - Tetanus?

0:12:17 > 0:12:19Yes. Hep A and rabies. Broad cover.

0:12:19 > 0:12:22- This is the sum total of her notes? - I know they're not extensive.

0:12:22 > 0:12:26But I always say the same thing, please don't shoot the messenger.

0:12:26 > 0:12:30From some countries, notes, legible, comprehensible notes,

0:12:30 > 0:12:33can be a rarity. I do have my own observations recorded in transit.

0:12:33 > 0:12:36- OK.- I'd like a quick word. - Excuse me.

0:12:37 > 0:12:41You cannot just swoop in and steal my patient.

0:12:41 > 0:12:43- I'm sorry, I have to.- Really?

0:12:43 > 0:12:45NHS guidelines stipulate in the event

0:12:45 > 0:12:49of an intercontinental repatriation from a high risk country, the senior consultant should attend.

0:12:49 > 0:12:52- And I'm a senior consultant. - And I'm the lead.

0:12:52 > 0:12:57This is in no way a reflection upon your abilities, Michael. Simply routine protocol.

0:12:59 > 0:13:04Michael. That sebaceous cyst in bed seven needs your attention.

0:13:05 > 0:13:10Can you believe I spent £75 on a crystal consultant,

0:13:10 > 0:13:12for her to find a crystal

0:13:12 > 0:13:16that resonates sympathetically with my body rhythms?

0:13:16 > 0:13:18So, why Raymond?

0:13:18 > 0:13:21Why Raymond, or why give my cancer a name like Raymond?

0:13:21 > 0:13:24- Either. Both. I don't know. - If you had cancer, what would you call it?

0:13:24 > 0:13:26I'm not sure if I'd call it anything.

0:13:26 > 0:13:28You got children?

0:13:28 > 0:13:31- Yes. Two boys. - And when they were inside you?

0:13:33 > 0:13:36- Blob and Flipper.- Sweet.

0:13:36 > 0:13:39- But I don't understand the... - It helps. To give it a name.

0:13:39 > 0:13:41When I had lung cancer, first time round,

0:13:42 > 0:13:44in a children's ward, we had art therapy.

0:13:44 > 0:13:48They made us visualise our diseases and paint pictures of them.

0:13:48 > 0:13:51And what did you paint?

0:13:51 > 0:13:54Raymondo. They even suggested I write a letter to my cancer.

0:13:54 > 0:13:55What happened?

0:13:55 > 0:13:58Raymond wrote back. Wanted to be my friend.

0:13:59 > 0:14:03You know this cancer is totally different.

0:14:03 > 0:14:06The goitre on your thyroid isn't connected

0:14:06 > 0:14:08in any way to the tumour you had on your lung.

0:14:08 > 0:14:11Still Raymond, believe me.

0:14:12 > 0:14:13Who is that?

0:14:13 > 0:14:16That is Doctor Valentine.

0:14:16 > 0:14:18- Yum.- You like?

0:14:18 > 0:14:22Sorry, I've been in and out of cancer wards since I was 16,

0:14:22 > 0:14:25- I think I've developed a bit of a thing for doctors.- Yes. So have I.

0:14:25 > 0:14:28Not that one. Another one.

0:14:28 > 0:14:30The one I married.

0:14:30 > 0:14:34Doctors and nurses. Nurses and nurses. Doctors and doctors.

0:14:34 > 0:14:35They're all at it, you know.

0:14:35 > 0:14:38I bet you've seen some hot goings on in this place.

0:14:38 > 0:14:40We need to run another test.

0:14:40 > 0:14:42Oh, come on! Now, you're just changing the subject.

0:14:42 > 0:14:45I'll see you later.

0:14:48 > 0:14:52- Is there a Mrs Brodrick? - Apart from my mother? No.

0:14:52 > 0:14:55- On your own then?- Blissful. Can do what I want, when I want.

0:14:55 > 0:14:56Doesn't get lonely?

0:14:56 > 0:15:00I live six doors from the Butcher's Arms.

0:15:00 > 0:15:02I'm captain of the darts team,

0:15:02 > 0:15:07co-compiler of the monthly pub quiz and treasurer of the Cwmbargoed Rugby Supporters Club.

0:15:07 > 0:15:08How am I going to get lonely?

0:15:13 > 0:15:15Imagine reaching that age and still living by yourself.

0:15:15 > 0:15:17Does seem a bit sad.

0:15:17 > 0:15:22- Oh, it's going to be such a laugh. - What?- Sharing. You and me.

0:15:22 > 0:15:25- Yeah, Um Lleucu... - Shared-house mates aren't friends.

0:15:25 > 0:15:27- No?- Not really.

0:15:27 > 0:15:29You live together, but mostly you just try and not fall out.

0:15:29 > 0:15:31Not like us?

0:15:31 > 0:15:34No. We're friends who want to live together, because we're friends.

0:15:34 > 0:15:38- Lleucu...- You know, you look really tired.

0:15:38 > 0:15:41What? No. Well, yes, knackered. But...

0:15:41 > 0:15:44- Why don't you go get a coffee? I can look out up here.- No. No, I...

0:15:44 > 0:15:47Go on. Get some caffeine in you!

0:15:49 > 0:15:52When she was conscious, did she give any indication of what she thought was wrong?

0:15:52 > 0:15:55Just abdominal pains.

0:15:56 > 0:15:58This looks like an old operation scar.

0:15:58 > 0:16:01- She mention any gynaecological surgery?- She didn't.

0:16:01 > 0:16:03Did you ask?

0:16:03 > 0:16:05All the information I have is in the envelope.

0:16:05 > 0:16:06I have to say,

0:16:06 > 0:16:10I've seen more comprehensive paperwork for a hiatus hernia.

0:16:10 > 0:16:13I'm sorry.

0:16:13 > 0:16:16I was being cheeky saying you're all at it at the whole time.

0:16:16 > 0:16:19- Bit stir-crazy bored. - Oh, it doesn't matter.

0:16:19 > 0:16:21But I appreciate you taking the time to talk.

0:16:21 > 0:16:26Lot of doctors just want to see my test results and pat me on the head.

0:16:26 > 0:16:28So is there a Mr Annabelle?

0:16:28 > 0:16:33Not any more. Raymond came between us.

0:16:33 > 0:16:34Shame.

0:16:34 > 0:16:36His loss.

0:16:36 > 0:16:40Right, I'm going to have to see more test results.

0:16:40 > 0:16:44And, I'll need to get some blood, right? So I'll get the nurse over.

0:16:44 > 0:16:47- Can you do it? - Yes. Of course I can.

0:16:47 > 0:16:50I'd like that.

0:16:57 > 0:16:59- You know what?- What?

0:16:59 > 0:17:03Let's go out tonight. Get a baby sitter. Catch a movie.

0:17:03 > 0:17:06We could even do a proper adult sit-down,

0:17:06 > 0:17:09face each other over a glass of wine, type dinner.

0:17:09 > 0:17:11What, you mean in a proper restaurant?

0:17:11 > 0:17:15- One that doesn't have high-chairs and colouring crayons?- Yep.

0:17:15 > 0:17:20Could you possibly sign my hand-over papers and I'll be out of your hair.

0:17:20 > 0:17:22No, not until I'm satisfied you've provided

0:17:22 > 0:17:25all the information I require. I will let you know when that is.

0:17:25 > 0:17:28Some people get the wrong idea about repatriation doctors.

0:17:28 > 0:17:31Assume we're all just about Air Miles and Happy Hours.

0:17:31 > 0:17:34Really? I can't think why.

0:17:40 > 0:17:42Your boss always so warm and engaging?

0:17:42 > 0:17:48Well, she didn't get to become a fellow by being one of the lads.

0:17:48 > 0:17:49How's the patient?

0:17:49 > 0:17:53Temperature's still rising. Breathing's a bit bated.

0:17:53 > 0:17:57Swelling around the abdomen. Anyway, the Snow Queen's booked her in for a scan.

0:17:57 > 0:18:01- She say what she thinks it is? - Possible tumour, is her guess.

0:18:01 > 0:18:04Really? May I?

0:18:04 > 0:18:06Knock yourself out.

0:18:06 > 0:18:09Hang on a minute. You still haven't told her you're flying to Spain

0:18:09 > 0:18:11the same weekend she expects you to be lumping boxes?

0:18:11 > 0:18:14She's so excited about moving in. Making lists...

0:18:14 > 0:18:17Come on, are you really thinking about cancelling the holiday?

0:18:17 > 0:18:21No way! Can you imagine what it'd be like if they all went without me?

0:18:21 > 0:18:23They all had all this much fun without me.

0:18:23 > 0:18:26For weeks, for months, for ever, I'd be all like,

0:18:26 > 0:18:28"Oh, what about when we went to Ibiza? Shaz did this,

0:18:28 > 0:18:31"and Lexi did that, Lucy got trollied and snogged a lifeguard."

0:18:31 > 0:18:34Oh, my God, Seriously, I'd rather die.

0:18:34 > 0:18:38- OK. I get it. You don't want to miss out. So, tell Lleucu, then! - Do you think?

0:18:38 > 0:18:41She's a mate, right? She'll understand.

0:18:41 > 0:18:43'Postpone?!'

0:18:43 > 0:18:45Just for a week.

0:18:45 > 0:18:48No! Why? Why pay rent for a week on a flat we're not living in?

0:18:48 > 0:18:51- That's crazy. - It's just, I can't do...

0:18:51 > 0:18:53- Is this about money?- No.

0:18:53 > 0:18:55Is that why you've been doing double shifts?

0:18:55 > 0:18:58No. Well, yes. It's the money. But not because...

0:18:58 > 0:18:59Don't worry about the money.

0:18:59 > 0:19:03I've already written a cheque for the advance-rent. Pay me later.

0:19:03 > 0:19:05- No, I can't.- End of story.

0:19:11 > 0:19:14I have to say, I admire your tenacity,

0:19:14 > 0:19:16working with a Valley Girl.

0:19:16 > 0:19:19Welsh women, they can boss the spots off a leopard.

0:19:24 > 0:19:27Let's see, what do you think?

0:19:27 > 0:19:30Pulse is a little raised,

0:19:30 > 0:19:34heart is fast, this mass in the pelvis, on the pubic bone.

0:19:34 > 0:19:37Dense mass, difficult to categorise. Could certainly be a tumour, desmoid, maybe?

0:19:37 > 0:19:40- They do so like to grow in old operation scars.- Desmoid tumour?

0:19:40 > 0:19:43- Come on!- Do you not have patients of your own?

0:19:43 > 0:19:46Last time I looked, our ward was full to capacity.

0:19:46 > 0:19:51Does the fact that she's just travelled extensively through West Africa not figure in your diagnosis?

0:19:51 > 0:19:54She was very well vaccinated. Her insurance documents clearly...

0:19:54 > 0:19:58I've a good friend who works in the Infectious Diseases Department of Addenbrooke's.

0:19:58 > 0:20:02- Let me call him and get his opinion, before you... - I don't think that's necessary.

0:20:02 > 0:20:06Temperature, raised Y-count and CRP, sweats, history of foreign travel,

0:20:06 > 0:20:10if this was an exam question, the obvious answer would be malaria or another tropical disease.

0:20:10 > 0:20:13And all those symptoms would go with a tumour too.

0:20:13 > 0:20:16Particularly if it had an inflammatory component or had perforated.

0:20:16 > 0:20:20Exam questions are simple logic. As you and I are aware, real life isn't.

0:20:21 > 0:20:24- I've got to be somewhere. - I'm taking her to theatre.

0:20:24 > 0:20:26- What if that mass is caused by infection?- Then we can drain it.

0:20:26 > 0:20:29- Not if it's TB, it may not heal. - Thank you, Michael.

0:20:31 > 0:20:34So, that's Raymond?

0:20:34 > 0:20:38That is your thyroid gland. And the shadowy mass is your tumour,

0:20:38 > 0:20:42pushing against your trachea, which is what's making you breathless.

0:20:42 > 0:20:46- So he's trying to strangle me. - Oh, he is, indeed.

0:20:46 > 0:20:49But what concerns me is exactly how far the tumour

0:20:49 > 0:20:52- extends down behind the sternum into your chest.- Mr Hanssen?

0:20:52 > 0:20:55Which coincidentally is exactly where Ms Shah comes in.

0:20:55 > 0:20:58We were just discussing the crossover between my area,

0:20:58 > 0:21:01the tracheal obstruction, and yours, the heart.

0:21:01 > 0:21:05I do trust that Ms Shah has been looking after you satisfactorily?

0:21:05 > 0:21:08- Can I have a word? - Yeah. She's cool. We like her.

0:21:08 > 0:21:10I thought you might. Excuse us, please.

0:21:15 > 0:21:18I've looked over her scans, it occurred to me that you could

0:21:18 > 0:21:21go through the neck and do a standard low collar incision.

0:21:21 > 0:21:22That's very interesting.

0:21:22 > 0:21:25- But would the position of the mass not preclude that approach?- No.

0:21:25 > 0:21:27I know it compromises the trachea,

0:21:27 > 0:21:30but I am completely confident that you could get access to it.

0:21:30 > 0:21:34It's less invasive, there's no need to crack the chest

0:21:34 > 0:21:38and put her on bypass, so a shorter post-op stay.

0:21:38 > 0:21:40Very good. We'll do it together. That's why I asked you to assist.

0:21:40 > 0:21:44No, you asked me to consult. I can't assist.

0:21:44 > 0:21:48- Sorry, you can lead on the cardiac procedure, of course. - My schedule today is jammed.

0:21:48 > 0:21:50Well, then I suggest you unjam it.

0:21:50 > 0:21:54- I've arranged something after work. - And this is work.

0:21:59 > 0:22:03If I asked you if you were in any pain, I bet you're the sort of bloke who would say...

0:22:03 > 0:22:06Nothing I can't handle, thank you very much.

0:22:06 > 0:22:10Which is why, I want you to take these. Take them!

0:22:12 > 0:22:14You're really quite good at your job.

0:22:14 > 0:22:17- I try...- Chantelle.

0:22:17 > 0:22:19Excuse me.

0:22:22 > 0:22:24Put that in your pocket.

0:22:24 > 0:22:26- What is it?- £65.- What?

0:22:26 > 0:22:29For the van. We said we'd pay half up front. I know you don't have it.

0:22:29 > 0:22:30No. I do.

0:22:38 > 0:22:41You've got a really good mate there.

0:22:41 > 0:22:44Not many friends in this world you can trust with money stuff.

0:22:46 > 0:22:48Can I ask you something, hypothetical?

0:22:48 > 0:22:49Like a "what if?"

0:22:51 > 0:22:54Yeah, like what if a group of your mates, right,

0:22:54 > 0:22:57were going to a rugby match, and you couldn't go?

0:22:57 > 0:23:00What was I doing that I had to miss the match?

0:23:00 > 0:23:04Um, housework?

0:23:04 > 0:23:07Housework? Big match and I'm stopping home to hoover?

0:23:07 > 0:23:11- Are you taking the...? - No, honest. I want your advice.

0:23:11 > 0:23:15- How?- Lleucu thinks I'm moving into a flat with her in a couple of weeks.

0:23:15 > 0:23:17I'm meant to be arranging a van.

0:23:17 > 0:23:21But actually I'm going to Ibiza with some other mates, old mates,

0:23:21 > 0:23:23- school mates.- So?

0:23:24 > 0:23:27I don't want her to get the hump.

0:23:27 > 0:23:30But I'd be gutted not to go. I don't know,

0:23:30 > 0:23:32- should I cancel, or... - Are you soppy?

0:23:32 > 0:23:36You could be hanging out in the Balearics or packing your sock drawer!

0:23:36 > 0:23:42Talk about youth being wasted on the young! Carpe diem, duchess.

0:23:42 > 0:23:44Seize the day.

0:23:46 > 0:23:49- Hey, I'm not trying to prove a point here.- Of course.

0:23:49 > 0:23:52I talked through every detail of the journey with Dr Summerville.

0:23:52 > 0:23:54On the flight, her vitals dropped very rapidly.

0:23:54 > 0:23:57If this was a tumour the decline would have been far more gradual.

0:23:57 > 0:24:00I've seen test results, CT scans, ultra sounds, bloods.

0:24:00 > 0:24:04I have all the empirical evidence I need to make my decision about my patient.

0:24:04 > 0:24:05I think you need to watch and wait.

0:24:05 > 0:24:08I think we should relieve a girl of a tumour that left untreated

0:24:08 > 0:24:10could affect her chances of ever becoming a mother.

0:24:10 > 0:24:13A desmoid tumour? You don't you think that's a huge leap?

0:24:13 > 0:24:16Patient's B/P is in her boots, 70 over 40. Temperature's raised,

0:24:16 > 0:24:17she's tachycardic.

0:24:17 > 0:24:21That's all the evidence I need. Now is the time to operate. Waiting is not an option.

0:24:21 > 0:24:24If you're genuinely so concerned then

0:24:24 > 0:24:26please feel free to scrub in and assist me.

0:24:28 > 0:24:30I spend my life hustling to try and get interesting theatre time.

0:24:30 > 0:24:34- I know.- So, why would you voluntarily give up an amazing thyroidectomy?

0:24:34 > 0:24:37I assisted lots when I joined Mr Hanssen at St Barts.

0:24:37 > 0:24:40For a while, he specialised in thyroid.

0:24:40 > 0:24:44It would be a great notch on your belt if he let you do the excision.

0:24:44 > 0:24:46- Sure.- And I really think you can do it.

0:24:46 > 0:24:48Especially with Mr Hanssen leading the procedure.

0:24:48 > 0:24:51It's the most secure safety net you could wish for.

0:24:51 > 0:24:52The most scary safety net.

0:24:52 > 0:24:56Challenging, yes, but fascinating theatre.

0:24:58 > 0:25:00And, you'd be doing me a favour.

0:25:00 > 0:25:04I have to be somewhere on time. And she likes you.

0:25:04 > 0:25:07- Who?- Annabelle Taylor, she thinks you're cute.

0:25:07 > 0:25:10And that's a good reason to go digging around her thyroid?

0:25:12 > 0:25:15Believe me, Ollie, if I wasn't sure you could do it,

0:25:15 > 0:25:18I wouldn't ask. And Hanssen will be there.

0:25:21 > 0:25:25I will start by excising the old scar.

0:25:25 > 0:25:27CLASSICAL MUSIC PLAYS

0:25:30 > 0:25:32OK, some blood here. Suction, please.

0:25:32 > 0:25:35SUCTION MACHINE

0:25:35 > 0:25:37Now, deepening the wound.

0:25:37 > 0:25:39What's with the commentary?

0:25:40 > 0:25:42Increasing the depth of incision.

0:25:42 > 0:25:45You do this when you're cooking?

0:25:45 > 0:25:47MACHINE ALARM BEEPS

0:25:50 > 0:25:53Could do with an extra pair of hands here, Mr Spence.

0:25:53 > 0:25:55All right. Pack it. I'm going to make the wound bigger.

0:25:55 > 0:25:57Give me a little room.

0:26:02 > 0:26:03I can't take it.

0:26:03 > 0:26:06- I don't want it back. You need it. - No.

0:26:06 > 0:26:08Some months it might be me who's short, and you'd help me out.

0:26:08 > 0:26:11That's how sharing works, right?

0:26:11 > 0:26:14I've got plenty of money, Lleucu. I'm doing double shifts!

0:26:14 > 0:26:16I lied.

0:26:17 > 0:26:18About the money?

0:26:18 > 0:26:23About Ibiza. When I said I'd cancel it.

0:26:23 > 0:26:25I didn't.

0:26:25 > 0:26:27Oh.

0:26:27 > 0:26:30That's why I can't move in on the seventh. I'm flying.

0:26:30 > 0:26:31You told me you'd cancelled it.

0:26:31 > 0:26:34That's why I've been doing extra work, to pay for the trip.

0:26:34 > 0:26:37I didn't know the dates would clash.

0:26:37 > 0:26:38You lied to me.

0:26:38 > 0:26:41I just wanted to go and have some fun with my mates.

0:26:43 > 0:26:45I thought I was your mate?

0:26:45 > 0:26:47- Lleucu...- No.

0:26:50 > 0:26:54There's an enterotomy in the bowel! Retractor. Clips.

0:26:54 > 0:26:57The bowel's blown. It's just falling apart!

0:26:57 > 0:26:59- B/P's crashing. - I can't stop the bleed!

0:26:59 > 0:27:03No way! It's a rectal sheath haematoma.

0:27:03 > 0:27:08We were both wrong! All right, let's adjust those lights.

0:27:08 > 0:27:10And kill the music.

0:27:10 > 0:27:12I'm going to recommend morphine and for the pre-op hyoscine,

0:27:12 > 0:27:14which will calm you before you go in.

0:27:14 > 0:27:15All those chemicals.

0:27:15 > 0:27:19Believe me, I would love to just give you a camomile infusion,

0:27:19 > 0:27:23but I don't think you'll thank me when they start doing their stuff.

0:27:23 > 0:27:26Miss Taylor, I am very glad that I asked Ms Shah

0:27:26 > 0:27:28to have look at your case,

0:27:28 > 0:27:31because she's come up with a ingenious alternative treatment.

0:27:31 > 0:27:33I know you've been through a lot of surgery

0:27:33 > 0:27:36and hospital time before with your lung operation...

0:27:36 > 0:27:40So, this time, she's suggesting we make a tiny incision in your neck and excise the tumour.

0:27:40 > 0:27:44You're going to pull Raymond out my neck? Sounds freaky!

0:27:44 > 0:27:47That way, much less time in hospital after the op.

0:27:47 > 0:27:50Don't want to sound ungrateful, but the sooner I'm out of here, the better.

0:27:50 > 0:27:53I won't be in theatre but my colleague,

0:27:53 > 0:27:57Dr Valentine, will be assisting.

0:27:57 > 0:27:58Ooh, lovely.

0:27:58 > 0:28:03I've already discussed in detail exactly how to take Raymond out without...

0:28:03 > 0:28:07Ms Shah, I was under the impression that you would be with me in theatre.

0:28:07 > 0:28:10Um, shall we?

0:28:14 > 0:28:17Let's keep the suction. Clips and 2-0 Prolene.

0:28:17 > 0:28:20- It's a write-off. - No. I've seen worse.

0:28:20 > 0:28:22We'll have to resect the entire bowel.

0:28:22 > 0:28:25She's 19-years-old, she does not need to lose it. We can save this.

0:28:25 > 0:28:27It's just disintegrating in my hands.

0:28:27 > 0:28:31Somehow I think you've never been to Mecklenburg County,

0:28:31 > 0:28:33West Virginia, in the fall.

0:28:36 > 0:28:38I won't be there. I did tell you earlier.

0:28:38 > 0:28:39Really?

0:28:39 > 0:28:42Dr Valentine will be assisting.

0:28:46 > 0:28:49I have a previous engagement. Something arranged some time ago.

0:28:49 > 0:28:51You see, what I really don't understand is why you think

0:28:51 > 0:28:54this kind of behaviour will in any way benefit your patient.

0:28:54 > 0:28:57Your patient. You asked me for my opinion.

0:28:57 > 0:28:59I already told you today was...

0:28:59 > 0:29:01Are you confident Dr Valentine is up to the job of assisting?

0:29:01 > 0:29:04Yes. I am. He's been fully prepped.

0:29:05 > 0:29:08Very well.

0:29:11 > 0:29:13Silk sutures, please.

0:29:14 > 0:29:18Now, Mecklenburg County is the wild turkey hunting capital

0:29:18 > 0:29:21of West Virginia.

0:29:21 > 0:29:25And while you were studying for all your PhDs,

0:29:25 > 0:29:28I was doing an internship at Mecklenburg County General.

0:29:28 > 0:29:31As my tobacco-chewing Senior Consultant used to say to me,

0:29:31 > 0:29:34"Mikey-Boy, you wanna learn

0:29:34 > 0:29:36"how to fix gun-shot wounds,

0:29:36 > 0:29:39"then you're going to need to learn how to crochet."

0:29:43 > 0:29:45You work your way around here.

0:29:45 > 0:29:47Look, and if you need to use an endoscope

0:29:47 > 0:29:49to get the remaining part out, then you can.

0:29:49 > 0:29:53Wouldn't it be much simpler just to zip open the chest?

0:29:53 > 0:29:55Yeah, simpler for you. Not for her.

0:29:55 > 0:29:57Thank you. What if I can't do it?

0:29:57 > 0:30:02You can. And with Mr Hanssen's guidance, you'll be fine.

0:30:02 > 0:30:06This is not my territory. You and Hanssen have a lot of previous.

0:30:06 > 0:30:09I'd be happy to do it if you were there.

0:30:09 > 0:30:12But if you were there, I wouldn't be doing it, would I?

0:30:13 > 0:30:16Are you nervous, Dr Valentine?

0:30:16 > 0:30:19Because my colleague seems to think I have every reason to trust you.

0:30:19 > 0:30:20She's very kind.

0:30:20 > 0:30:23Ms Shah and I together have performed many thyroidectomies.

0:30:23 > 0:30:27Have you accomplished the procedure before?

0:30:27 > 0:30:28On a living patient?

0:30:31 > 0:30:35So shall we all just put our faith in Ms Shah's faith in you?

0:30:41 > 0:30:43Just doing your obs.

0:30:45 > 0:30:47I know that look.

0:30:47 > 0:30:49What?

0:30:49 > 0:30:52The face my mother had when she was about to explode to my dad.

0:30:52 > 0:30:54We saw that look in our house, we'd run a mile.

0:30:54 > 0:30:57Well, excuse me, if you'd made plans to move into a new flat

0:30:57 > 0:31:01with a friend and you'd arranged everything - agents, landlords, keys

0:31:01 > 0:31:03and all she had to do was book the van,

0:31:03 > 0:31:08then - THEN says she wasn't going to do it, cos she was going on holiday with her stupid friends

0:31:08 > 0:31:12with their stupid tangerine-tanned legs and their stupid smartphones,

0:31:12 > 0:31:14you'd want to explode too.

0:31:14 > 0:31:19Well, I guess your word is your bond, but...

0:31:19 > 0:31:22Maybe she didn't want to say anything to you

0:31:22 > 0:31:25because she was scared you might bite her head off.

0:31:25 > 0:31:26Really?

0:31:26 > 0:31:29I know that's why I never told my mum nothing.

0:31:32 > 0:31:35REGULAR BEEPS

0:31:42 > 0:31:44Swabs and suction, please.

0:31:46 > 0:31:47Thank you.

0:31:48 > 0:31:51So you've never removed a thyroid before, Dr Valentine?

0:31:51 > 0:31:53Only from a cadaver.

0:31:54 > 0:31:58Such a disappointing little gland, the thyroid, I always think.

0:31:58 > 0:32:03Scissors. Thank you.

0:32:03 > 0:32:06Lacking in any real power of its own.

0:32:06 > 0:32:09Like a puppet to the pituitary gland.

0:32:09 > 0:32:14You see, that's where the real power lies. Without the pituitary gland controlling its every move,

0:32:14 > 0:32:16the thyroid doesn't know what to do.

0:32:16 > 0:32:20The tumour wraps right around the back?

0:32:20 > 0:32:23Reaching right down is the world of the cardiothoracic surgeon.

0:32:23 > 0:32:26Your chance to slay the mighty Raymond.

0:32:28 > 0:32:31Scissors, please. Thank you.

0:32:44 > 0:32:47- Have you seen Rafi?- Sorry, no.

0:32:51 > 0:32:53I was wrong.

0:32:54 > 0:32:55Yes, you were.

0:32:56 > 0:32:58Bet you haven't said that a lot in your life.

0:32:58 > 0:33:00Kind of stings, doesn't it?

0:33:00 > 0:33:04Rectus sheath haematoma, and the small bowel must have stuck

0:33:04 > 0:33:06to the scar tissue from the old operation.

0:33:06 > 0:33:09Mm. Well, what are the odds, huh?

0:33:09 > 0:33:11I could've lost her.

0:33:12 > 0:33:16Yup. But, well, luckily Michael Spence was there.

0:33:16 > 0:33:20Ah, hey, there's no way you could've known before you went in.

0:33:20 > 0:33:21I could have waited.

0:33:21 > 0:33:25Well, all right, if it helps, I was wrong too.

0:33:25 > 0:33:27There's no sign of tropical infectious diseases

0:33:27 > 0:33:29so it's no-one's fault.

0:33:30 > 0:33:32I should've been more careful.

0:33:32 > 0:33:36Hey, you are the most careful surgeon I have ever met.

0:33:36 > 0:33:37Hey.

0:33:38 > 0:33:41I enjoy a moment of victory as much as the next guy

0:33:41 > 0:33:44and believe me I would like nothing more

0:33:44 > 0:33:48- than to lord it over you right now but not if you're going to cry about it.- I don't cry.

0:33:50 > 0:33:53OK. Look, it was a ticking time bomb.

0:33:53 > 0:33:56OK, if you hadn't gone in when you did,

0:33:56 > 0:33:58it could've blown and she would have bled out.

0:33:58 > 0:34:02So in that way, you were right. OK?

0:34:13 > 0:34:15LOUDER, SLOWER BEEPING

0:34:15 > 0:34:19BP's dropping, pulse is rising. It's safe to say we have a bleed.

0:34:19 > 0:34:20- Dr Valentine...- Swabs, please.

0:34:20 > 0:34:24- ..I think you've have sliced through a vessel in the tumour. - Fluids, cross-match bloods.

0:34:24 > 0:34:26Start her on adrenaline.

0:34:26 > 0:34:29It's riddled with its own blood vessels like it's its own separate living thing.

0:34:29 > 0:34:33The main supply for blood is direct to her aorta.

0:34:33 > 0:34:35We'd all rather you didn't slice through that one.

0:34:35 > 0:34:38- We may have to in order to get at the root of the tumour. - You think so, do you?

0:34:39 > 0:34:44I'm going to investigate further. Scalpel, please. Thank you.

0:34:49 > 0:34:51That better, Owen?

0:34:51 > 0:34:52Lovely, ta.

0:34:52 > 0:34:55Real friends don't lie to each other, do they, Owen?

0:34:55 > 0:34:57What? Er, no, no.

0:34:57 > 0:34:59Come on, Lleucu, be reasonable.

0:34:59 > 0:35:01Huh! I'm being unreasonable?

0:35:01 > 0:35:04Yeah. And it's not just me who thinks so.

0:35:04 > 0:35:06- Who else?- Malick.

0:35:06 > 0:35:08- Malick!- And Owen.

0:35:08 > 0:35:11Owen does not agree with you, he agrees with me. Don't you, Owen?

0:35:11 > 0:35:15He doesn't, do you? "Seize the day," that's what you said, isn't that right?

0:35:15 > 0:35:18Oh, really? What about, "Your word is your bond," huh, Owen?

0:35:21 > 0:35:24- BEEPING CONTINUES - Airway pressure going up, the SATS are down.

0:35:24 > 0:35:27Peak airway pressure greater than 30...

0:35:27 > 0:35:3160, and there's extensive pressure on the trachea. Bag her, please.

0:35:31 > 0:35:34We're not getting enough oxygen in. I'm sorry, we'll need to crack the chest.

0:35:34 > 0:35:36We need to get her onto bypass, now.

0:35:36 > 0:35:38It would seems Raymond is getting the better of you.

0:35:38 > 0:35:42- You may need the help of your esteemed colleagues. - Page the on-call perfusionist.

0:35:42 > 0:35:43And call Ms Shah.

0:35:43 > 0:35:45What? No, she had to leave...early.

0:35:45 > 0:35:49- Page Mr Hope or Ms Naylor. - Call Ms Shah, please. Tell her it's an emergency.

0:35:55 > 0:35:57Wow.

0:35:58 > 0:36:00Well, you've got to make an effort, right?

0:36:00 > 0:36:02Bit overdressed for the all-you-can-eat, but...

0:36:02 > 0:36:05Kidding! I booked the Korean BBQ.

0:36:05 > 0:36:06PAGER RINGS

0:36:08 > 0:36:10- Don't do it.- I have to.

0:36:10 > 0:36:12What's happened?

0:36:12 > 0:36:14When?

0:36:16 > 0:36:18OK, I'm on my way.

0:36:18 > 0:36:20- No!- I've got to.

0:36:20 > 0:36:22No, you don't. That's the whole point.

0:36:22 > 0:36:25That's what this is all about. Why you said no to Hanssen.

0:36:25 > 0:36:26If you give in now...

0:36:26 > 0:36:27This is not about Hanssen.

0:36:27 > 0:36:29It is, it always is.

0:36:29 > 0:36:31This is about a 25-year-old woman, a girl, for God's sake.

0:36:31 > 0:36:34Sahira, there will always be some woman, or girl, or boy,

0:36:34 > 0:36:36or little old man.

0:36:36 > 0:36:38You are not the only surgeon at Holby.

0:36:38 > 0:36:41- It's not fair on Ollie.- Ollie?!

0:36:41 > 0:36:45Yeah, I put him up to this. It's not working. I'm sorry.

0:36:46 > 0:36:48Wait for me.

0:36:53 > 0:36:55Hey. All good? Can I go now?

0:36:55 > 0:36:59My discharge papers, sign me out? I've got a rather nice suite at the Merchant

0:36:59 > 0:37:02and a very long, very cool drink, requiring my full attention.

0:37:02 > 0:37:05- Unfortunately I can't let you go until we find out what went wrong.- Wrong? In surgery?

0:37:07 > 0:37:09What happened?

0:37:09 > 0:37:13Rectus sheath haematoma above the inferior epigastric artery.

0:37:13 > 0:37:15Which means as soon as we opened her up...

0:37:15 > 0:37:18- What caused it?- I don't know. I was hoping you could tell me.

0:37:20 > 0:37:23- You gave her pain relief on the plane?- Morphine, 10 milligrams intra-muscular.

0:37:23 > 0:37:26- It's in the notes.- Where'd you give it to her?- Lower abdomen.

0:37:26 > 0:37:27Sitting or standing?

0:37:27 > 0:37:29- Sitting.- Was she reclining?

0:37:29 > 0:37:32No, she was in a lot of pain, so doubled-up.

0:37:32 > 0:37:34- Prefilled syringe? - Yeah, I just popped it straight in.

0:37:34 > 0:37:37Above the right iliac fossa?

0:37:39 > 0:37:41You don't know that for certain.

0:37:42 > 0:37:46Your needle nicked the artery, caused the RSH.

0:37:46 > 0:37:47Could've killed her.

0:37:52 > 0:37:55The tumour's too far in, we need to crack the chest.

0:37:55 > 0:37:56- Let me have one go. - Bypass is ready to go.

0:37:56 > 0:37:59One more try. Two minutes. If I don't get it, we stop.

0:37:59 > 0:38:02If the pressure doesn't come up, we use the rapid infuser.

0:38:02 > 0:38:06- It's a big one.- Come on, Raymond. - All the way in, around and down.

0:38:08 > 0:38:10Scissors.

0:38:10 > 0:38:12In by my index finger, 20 degrees.

0:38:16 > 0:38:18OK, cut.

0:38:38 > 0:38:41- Hello, Raymond. - And the beast is slain.

0:38:41 > 0:38:43I want a jar for this one.

0:38:43 > 0:38:45Well done, Ms Shah.

0:38:50 > 0:38:53I know it hurts, but you're going to need another dressing change.

0:38:53 > 0:38:55Can't keep wounds too clean. I'll send the nurses over.

0:38:55 > 0:38:57No!

0:38:57 > 0:39:00- It has to be done.- Can't you do it?

0:39:00 > 0:39:02- Yes, but they'll do a much better job...- Please.

0:39:02 > 0:39:05Is there a problem?

0:39:06 > 0:39:10I...put my foot in it, a bit, as usual.

0:39:11 > 0:39:14Women. They've always been a bit of a mystery, see.

0:39:17 > 0:39:22I called my mum and she said she'll move my stuff in, help get the place straight.

0:39:22 > 0:39:26- And Uncle Jerry's mate will still bring the van.- So I've got to do all the moving-in with your mum?

0:39:26 > 0:39:30- She's great at cleaning and arranging...- But I won't be living with your mum, will I?

0:39:31 > 0:39:35- I'm really sorry.- It doesn't matter. Just...

0:39:35 > 0:39:38Petty domestic squabbles have no place on this ward.

0:39:38 > 0:39:41I expect total clinical professionalism at all times.

0:39:41 > 0:39:45Is that understood? Now, you will both apologise to Mr Brodrick.

0:39:45 > 0:39:47You WILL be courteous to each other,

0:39:47 > 0:39:49and I don't want to hear another word of this.

0:39:56 > 0:40:01Thank you, Dr Valentine. And excellent work, Ms Shah.

0:40:01 > 0:40:03Just what I'm looking for, I think.

0:40:03 > 0:40:05In a consultant.

0:40:05 > 0:40:07You see, it's not just skills at the table.

0:40:07 > 0:40:11You're developing leadership qualities. You know when to assert, step in.

0:40:11 > 0:40:16Don't do the consultancy carrot thing. It's getting really old.

0:40:17 > 0:40:19Have you seen my husband, Dr Raza?

0:40:19 > 0:40:20No, sorry.

0:40:23 > 0:40:24Abandoned in your hour of victory?

0:40:24 > 0:40:29Don't pretend you can wave a magic wand and make me a consultant.

0:40:29 > 0:40:32This is the NHS. Riddled with protocol and regulations.

0:40:32 > 0:40:36And besides, there is no consultancy at Holby. All posts are filled.

0:40:36 > 0:40:38Really? You keep a score, do you?

0:40:38 > 0:40:42You do this every time you want to bring me back in line. Well, not this time!

0:40:42 > 0:40:46The consultancy post is new, actually. It's a unique opportunity.

0:40:46 > 0:40:50One appropriate for a surgeon with specialist Trauma Unit experience.

0:40:50 > 0:40:53Cardiac Trauma Unit experience, really.

0:40:54 > 0:40:57I don't really know many doctors with that experience. Do you?

0:41:06 > 0:41:07How's she doing?

0:41:07 > 0:41:12She's still hypotensive. Have we done post-op haemoglobin?

0:41:12 > 0:41:14Yeah. What are you still doing here?

0:41:14 > 0:41:17Thought you'd be off getting a drink and room service.

0:41:17 > 0:41:19Everyone, everywhere, every hospital,

0:41:19 > 0:41:21just assumes my job is a breeze.

0:41:21 > 0:41:23Fly down to Rio, check out the carnival.

0:41:23 > 0:41:25Bring home an errant diabetic.

0:41:25 > 0:41:27I'm sure it is harder than it looks.

0:41:27 > 0:41:29I took this job because I was sick of the system.

0:41:29 > 0:41:30Heard that.

0:41:30 > 0:41:34But I'm still a doctor. I still want to help my patients.

0:41:36 > 0:41:38This could ruin me.

0:41:38 > 0:41:39It was an accident.

0:41:39 > 0:41:41But I caused it.

0:41:43 > 0:41:45Personally, I don't see any reason to blame anyone.

0:41:45 > 0:41:48It's just an accident.

0:42:06 > 0:42:07You know...

0:42:09 > 0:42:12I know that Hanssen has me labelled as the miscreant.

0:42:12 > 0:42:14I get it.

0:42:14 > 0:42:17But do you know what I really am?

0:42:17 > 0:42:18A liability?

0:42:18 > 0:42:23Fallible. I'm fallible. I messed up. But I got back up.

0:42:24 > 0:42:28And I know that tumour diagnosis of yours was a complete fantasy,

0:42:28 > 0:42:31but you didn't cause the rectal shear haematoma.

0:42:31 > 0:42:33Dr Air Miles did.

0:42:33 > 0:42:35Dr Summerville did?

0:42:35 > 0:42:39Mm-hmm, so you can give yourself a break.

0:42:39 > 0:42:41Dr Summerville caused it. How?

0:42:41 > 0:42:42Accident. Pain relief injection.

0:42:42 > 0:42:45Thought he was doing the right thing. Doesn't matter.

0:42:45 > 0:42:47Important thing is how you do this job.

0:42:47 > 0:42:53And...as much as it pains me to see you doing the job I should be doing,

0:42:53 > 0:42:56I'd like to see it done properly. With some balls.

0:42:56 > 0:43:01If he pierced the inferior epigastric artery then,

0:43:01 > 0:43:03why did she collapse so fast?

0:43:03 > 0:43:05She was weak. Her immune system was compromised.

0:43:05 > 0:43:09That's kind of irrelevant now. What matters is that we move forward.

0:43:12 > 0:43:16Hi Rafi, it's me. I've been looking for you. Where are you?

0:43:16 > 0:43:17I'm in Darwin.

0:43:44 > 0:43:46She practically never sees her boys.

0:43:47 > 0:43:49What are you doing in my...?

0:43:49 > 0:43:54She's in theatre till midnight on some days. Many days. With you.

0:43:54 > 0:43:57I haven't been on a night out with her till midnight

0:43:57 > 0:44:00since as long as I can remember.

0:44:01 > 0:44:04Are you in the habit of barging into other people's offices?

0:44:05 > 0:44:07You already see more of my wife than I do.

0:44:07 > 0:44:09That may be so, but that...

0:44:09 > 0:44:12But still, you want more.

0:44:13 > 0:44:15If you'd like to discuss working hours,

0:44:15 > 0:44:19I suggest you contact HR and make an appointment.

0:44:19 > 0:44:21We will take it from there.

0:44:21 > 0:44:24What goes on in your head, Henrik? Really?

0:44:24 > 0:44:26I fail to see what you are referring to, I'm afraid.

0:44:29 > 0:44:32Nottingham. I had a perfectly good job on offer in Nottingham...

0:44:33 > 0:44:40Chief Anaesthetic Consultant. Lovely city. 120 miles of cycleways.

0:44:40 > 0:44:42I love cycleways, you might not know that about me.

0:44:42 > 0:44:44Well, I fail to see how this...

0:44:44 > 0:44:48No. Suddenly, I have a better job offer from Holby.

0:44:48 > 0:44:51From you.

0:44:51 > 0:44:54Here. So why should we move away, when we can stay?

0:44:54 > 0:44:57I think you should consider very carefully what it is

0:44:57 > 0:44:59you are saying to me.

0:44:59 > 0:45:02Doesn't it get boring? Controlling our lives?

0:45:02 > 0:45:05Aren't you bored with it yet? Because I am.

0:45:05 > 0:45:07What is it about her?

0:45:07 > 0:45:11What is it about my wife that is so special to you?

0:45:11 > 0:45:14That you couldn't bear to let her go?

0:45:14 > 0:45:18As a matter of fact, I was entirely ready to let her go.

0:45:18 > 0:45:21I was perfectly happy that she should throw away her career

0:45:21 > 0:45:24and follow you to Nottingham.

0:45:24 > 0:45:26There were others who...

0:45:28 > 0:45:30Others?

0:45:30 > 0:45:34One close colleague on Darwin who persuaded me that she

0:45:34 > 0:45:36was an essential asset to the ward.

0:45:36 > 0:45:38Which colleague?

0:45:45 > 0:45:48Mr Douglas was particularly insistent, I remember.

0:45:53 > 0:45:56I've signed your discharge form. You're free to go.

0:45:56 > 0:45:59That's OK. I'll stay until Louisa's mother arrives.

0:45:59 > 0:46:00I'd rather you left now.

0:46:02 > 0:46:05We'll be filing an untoward incident report on you.

0:46:06 > 0:46:09You're going to report him?

0:46:09 > 0:46:12It's my job to report all findings in every repatriation case

0:46:12 > 0:46:14- to avoid...- Being sued. I know that. What about his job?

0:46:14 > 0:46:18- He's obviously not very good at it. - If you write that report, he will get fired.

0:46:18 > 0:46:20That is an issue for his employers.

0:46:20 > 0:46:21It was an accident.

0:46:21 > 0:46:25- One in a thousand chance of nicking that artery.- It was a clinical error.

0:46:25 > 0:46:28- We all make them. Remember? - I'd like the report on my desk in an hour, please.

0:46:28 > 0:46:31- I'm not writing it. - You conducted the surgery.

0:46:31 > 0:46:33You have the most insight as to how it led to trauma.

0:46:33 > 0:46:37I'm not hanging him out to dry for the sake of some insurance company.

0:46:37 > 0:46:40- He does not deserve to be made a scapegoat.- I'll write it.

0:46:40 > 0:46:42It's my duty to the Trust and the insurers.

0:46:42 > 0:46:46- To end his career?- To be transparent. - To be insipid.

0:46:46 > 0:46:48What is it with that woman?

0:46:48 > 0:46:50It's obvious.

0:46:50 > 0:46:52What?

0:46:52 > 0:46:55You know. When you two are going at it like that, hammer and tongs,

0:46:55 > 0:46:59there's this...thing coming off you both.

0:46:59 > 0:47:02This chemistry, this frisson.

0:47:05 > 0:47:07I'm just putting it out there.

0:47:09 > 0:47:10It was all her idea.

0:47:15 > 0:47:17Oh, big deal. She's attracted to me.

0:47:17 > 0:47:20Who said it was that way round?

0:47:24 > 0:47:26I shouldn't have said anything to you.

0:47:28 > 0:47:30Or asked you anything personal.

0:47:30 > 0:47:33I'm sorry. I won't say another word.

0:47:33 > 0:47:39No. No. That's not right. It was my fault. I'm sorry.

0:47:39 > 0:47:42Nobody ever asks me anything about anything, see?

0:47:42 > 0:47:43Not really.

0:47:45 > 0:47:49I just wanted to say the right thing when you asked, that's all.

0:47:49 > 0:47:52So I went along with you. Went along with both of you.

0:47:52 > 0:47:53Seemed the right thing to do.

0:47:53 > 0:47:55Have me crying in a minute.

0:47:55 > 0:47:59Well, that you bloody can do elsewhere!

0:47:59 > 0:48:03- I was thinking about what you said about me mates and the rugby match. - That was just me being hypothetical.

0:48:03 > 0:48:06I got a lot of pub mates, see...

0:48:06 > 0:48:11but times like this, I wish I had real friendships.

0:48:11 > 0:48:13Like you've got with the Valley vixen.

0:48:14 > 0:48:17I don't think she thinks I'm much of a friend.

0:48:17 > 0:48:21What you were saying earlier... here's another hypothetical.

0:48:21 > 0:48:25If say, God forbid, one of my mates was into football...

0:48:25 > 0:48:29and he was off to see a big match with all his football mates,

0:48:29 > 0:48:31and he didn't ask me to bob along

0:48:31 > 0:48:34cos he thought I wouldn't enjoy the footy, like.

0:48:37 > 0:48:39Yeah, I would be right put out.

0:48:40 > 0:48:45Even if I didn't like football, I'd still liked to be asked.

0:48:52 > 0:48:54You mean...

0:48:54 > 0:48:55Lleucu might like to be asked

0:48:55 > 0:48:58if she wants to go to the...football.

0:49:03 > 0:49:07MACHINE BEEPS

0:49:07 > 0:49:09Louisa...Louisa!

0:49:09 > 0:49:12LOUD BEEPING

0:49:17 > 0:49:19What's going on here?

0:49:21 > 0:49:25Between me and you. All the fighting,

0:49:25 > 0:49:29the clashing swords, locking horns...

0:49:29 > 0:49:34Locking horns? We're senior surgeons, not rutting bucks.

0:49:34 > 0:49:36Is that what's going on here?

0:49:36 > 0:49:38I'm sorry, you've lost me.

0:49:38 > 0:49:41OK, I'm going to be honest with you right now.

0:49:41 > 0:49:44There is something about you that I cannot reconcile.

0:49:44 > 0:49:49There's something about the way you are - something about the way

0:49:49 > 0:49:53that WE are. Maybe this isn't just professional tension.

0:49:54 > 0:49:57Maybe it's physical? Biological?

0:49:57 > 0:49:59I may be wildly off base here, and hope that I am,

0:49:59 > 0:50:04but, is there something unresolved between us we need to resolve to move on and work together?

0:50:05 > 0:50:07What are you talking about?

0:50:07 > 0:50:11I don't know. It's just what the others are saying...

0:50:11 > 0:50:14What others?

0:50:15 > 0:50:18What the others see between you and me.

0:50:20 > 0:50:21Is it real?

0:50:21 > 0:50:23You and me?

0:50:25 > 0:50:27Quick, Louisa's fitting!

0:50:31 > 0:50:34What are you doing? What did you give her?

0:50:34 > 0:50:37Naloxone. Soon as she was given pain relief, she crashed.

0:50:37 > 0:50:39Opiate intolerance.

0:50:39 > 0:50:42That's why she went down so quickly on the plane.

0:50:42 > 0:50:45- Good work. - Heart rate's improving.

0:50:51 > 0:50:55I'd like to see you in my office, Mr Spence. Now, please.

0:51:07 > 0:51:11"Maybe this is just physical, biological."

0:51:13 > 0:51:15OK.

0:51:15 > 0:51:18"Something unresolved that we need to resolve."

0:51:18 > 0:51:19Look, I was just...

0:51:19 > 0:51:22Firstly, I would like to point out that your suggestion

0:51:22 > 0:51:25and your over-familiarity provide me

0:51:25 > 0:51:28with perfectly legitimate grounds to pursue a case of sexual harassment.

0:51:28 > 0:51:29No. Come on!

0:51:29 > 0:51:32Secondly, I'd never in any way jeopardise my professional integrity

0:51:32 > 0:51:36by having intimate relations with a colleague.

0:51:36 > 0:51:38No. Of course. Accepted. That was way out of order.

0:51:38 > 0:51:40If I were looking for a relationship,

0:51:40 > 0:51:43you would possibly be the last man on the entire planet...

0:51:43 > 0:51:49OK. Totally, I totally get it.

0:51:49 > 0:51:51That was way out of line.

0:51:51 > 0:51:53- But...- And I apologise.

0:51:55 > 0:51:56But?

0:51:56 > 0:51:58But...

0:51:58 > 0:52:03I would, however, accept an invitation for a drink.

0:52:03 > 0:52:06A glass of wine, perhaps. Purely on a platonic understanding.

0:52:08 > 0:52:09Right.

0:52:09 > 0:52:11Great.

0:52:15 > 0:52:16Fine.

0:52:16 > 0:52:18Good.

0:52:23 > 0:52:26So...what about Summerville?

0:52:26 > 0:52:28That's not your call.

0:52:28 > 0:52:31No. Of course.

0:52:33 > 0:52:35You're in charge.

0:52:42 > 0:52:44You made it.

0:52:47 > 0:52:49Did you get him?

0:52:50 > 0:52:53You're going to find it hard to talk for a few days.

0:52:53 > 0:52:56Take it easy. Do you want to see him?

0:52:56 > 0:53:00I don't know...do I?

0:53:01 > 0:53:04Sometimes it helps. You know, face our demons.

0:53:06 > 0:53:12It's like your art therapist. I thought seeing it,

0:53:12 > 0:53:15him, would help you visualise.

0:53:15 > 0:53:19Help you understand that now it's gone from being inside you,

0:53:19 > 0:53:21it's over.

0:53:21 > 0:53:22Thank you.

0:53:22 > 0:53:24Pleasure.

0:53:29 > 0:53:33But...how do I know that's Raymond, that's really him?

0:53:33 > 0:53:34Who else could it be?

0:53:34 > 0:53:38What if he's still hiding inside me, like the last time?

0:53:38 > 0:53:42This is Raymond. He's gone.

0:53:43 > 0:53:46Had us worried there for a bit.

0:53:46 > 0:53:50Raymond was a tricky customer. Had me foxed.

0:53:50 > 0:53:52You were very lucky that Ms Shah came back.

0:53:52 > 0:53:55It was a team effort.

0:53:55 > 0:53:58We're both very lucky Ms Shah decided to ditch her night out.

0:54:08 > 0:54:09Hey. She's stable now,

0:54:09 > 0:54:12so you're free to go drink your bodyweight in Margaritas.

0:54:12 > 0:54:15No. I'm going to wait for her mother to arrive.

0:54:15 > 0:54:18Her flight's been delayed again.

0:54:18 > 0:54:19Where you off to next?

0:54:19 > 0:54:21Madeira.

0:54:21 > 0:54:24Elderly hiker overdid it on a mountain walk. Popped a valve.

0:54:24 > 0:54:26Certainly beats working for a living, right?

0:54:26 > 0:54:27If you're interested,

0:54:27 > 0:54:30there's a bunch of repatriation agencies

0:54:30 > 0:54:32I'm sure would snap up a frontline doctor like you.

0:54:32 > 0:54:38Thank you, very flattering. But I think I'm happy where I am.

0:54:39 > 0:54:44I just thought I'd let you know, I've decided against filing

0:54:44 > 0:54:48an untoward incident report on what happened with Louisa Tindle.

0:55:14 > 0:55:16Good to see you. Good to see you.

0:56:23 > 0:56:24Hey. Where were you?

0:56:24 > 0:56:25Went for a walk.

0:56:34 > 0:56:37You just changed your mind about Dr Summerville?

0:56:37 > 0:56:41On reflection, I may have been a little bit...hard.

0:56:41 > 0:56:42So I was right again?

0:56:44 > 0:56:45Goodnight, Michael.

0:56:45 > 0:56:47You want to get that drink?

0:56:48 > 0:56:50Maybe next time.

0:56:53 > 0:56:54Night, boss.

0:57:20 > 0:57:23Subtitles by Red Bee Media Ltd